Acute gastroenteritis: Difference between revisions

(viral, staph)
(noninvasive)
Line 30: Line 30:
|| Yes
|| Yes
|-
|-
| [[Bacillus cereus|B. cereus]]|| 1-6 hrs|| Example || Example || Yes
| [[Bacillus cereus|B. cereus]]
|| 1-6 hrs
||  
*Abrupt onset of nausea, vomiting, mild diarrhea
||  
*Previously cooked foods (rice, vegetables, dried fruits, meat)
|| Yes
|-
|-
| [[Clostridium (not difficile)|C. perfringens]]|| 8-24 hrs|| Example || Example || Yes
| [[Clostridium (not difficile)|C. perfringens]]
|| 8-24 hrs
||  
*Nausea, minimal vomiting, watery diarrhea
*Abd cramps
||  
*Previously cooked or reheated meats and poultry
|| Yes
|-
|-
| [[Vibrio cholera|V. cholerae]]|| 11-72 hrs ||  
| [[Vibrio cholera|V. cholerae]]|| 11-72 hrs ||  
*Explosive rice-water diarrhea
*Vomiting, abd cramps
*Fever
||
*Fecal-oral  
*Fecal-oral  
*Contaminated food or water  
*Contaminated food or water  
|| Example || No
|| No
|-
|-
| [[Giardia]]|| 1-4 wks|| Example || Example || No
| [[Giardia]]
|| 1-4 wks
||  
*Flatus, bloating
*Foul-smelling and fatty stools (steatorrhea)
||  
*Fecal-oral
*Contaminated water
|| No
|}
|}



Revision as of 05:58, 31 October 2015

Background

  • Blood diarrhea suggests bacterial etiology
  • Viral AGE usually lasts <7d
  • Do not dx isolated vomiting as AGE

Causes

Noninvasive AGE
Species Onset Symptoms Transmisison Preformed Toxin
Viral 11-72 hrs
  • Nausea, vomiting, watery diarrhea
  • Mild abd cramps, myalgia
  • Fecal-oral
  • Contaminated food or water
No
Staph 1-6 hrs
  • Nausea, severe vomiting, diarrhea,
  • Mild abd cramping
  • Previously cooked foods (mayonaise, ham, salads)
Yes
B. cereus 1-6 hrs
  • Abrupt onset of nausea, vomiting, mild diarrhea
  • Previously cooked foods (rice, vegetables, dried fruits, meat)
Yes
C. perfringens 8-24 hrs
  • Nausea, minimal vomiting, watery diarrhea
  • Abd cramps
  • Previously cooked or reheated meats and poultry
Yes
V. cholerae 11-72 hrs
  • Explosive rice-water diarrhea
  • Vomiting, abd cramps
  • Fever
  • Fecal-oral
  • Contaminated food or water
No
Giardia 1-4 wks
  • Flatus, bloating
  • Foul-smelling and fatty stools (steatorrhea)
  • Fecal-oral
  • Contaminated water
No
Invasive AGE
Species Onset Symptoms Transmission
Salmonella 6-72 hours
  • Eggs
  • Poultry
  • Water
  • Reptiles
Shigella 1-3 days
  • Food
  • Fecal-Oral
Yersinia 1-5 days
  • Water
  • Milk
  • Pork
  • Wild Animals
  • Fecal-Oral
Campylobacter 1-7 days
  • Water
  • Poultry
  • Pets/Animals
C. Diff 1-11 Weeks
  • Copious FOUL diarrhea
Entamoeba 1-11 weeks
  • Water
  • Sanitation
  • Travel

Clinical Features

Differential Diagnosis

Diffuse Abdominal pain

Diagnosis

  • Assess hydration status
    • Cap refill, skin turgor, resp rate
  • Consider stool labs if:

Treatment

  1. Oral rehydration therapy
    • 30mL(1oz)/kg/hr
  2. Antiemetic
  3. Antibiotics

Disposition

See Also

References